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Jill Williams, M.D. (in photo) of Rutgers University-Robert Wood Johnson Medical School and colleagues examined the effectiveness of a two-day training curriculum on changing clinical practice by reviewing clinical charts from 20 clinicians who attended the training in 2012. Ten medical records were randomly selected for review from each clinician’s outpatient practice at a large behavioral health system, including five charts from smokers seen within six months before and after training.
The training included a comprehensive review of behavioral and pharmacologic treatments and techniques on how to work with less-motivated smokers and to develop treatment plans for smokers with behavioral health conditions. Several sessions involved interactive learning through case studies, small-group problem solving, and skills practice sessions.
Documentation of tobacco use significantly increased between baseline and post-training. Also, after the training, clinicians advised significantly more outpatients to quit (9% before versus 36% after) or referred them to individual or group counseling. Discussion of nicotine replacement was documented more frequently in charts (10% versus 31%), and prescriptions for smoking-cessation medications increased significantly in the post-training period, although overall prescribing remained low. The number of patients making quit attempts also significantly increased after the training (10% versus 39%), suggesting that providers were delivering more tobacco treatment than was reflected in charts.
“This study was the first to evaluate how training behavioral health professionals through a CE [continuing education] curriculum affects the delivery of tobacco-dependence treatments in the behavioral health setting,” the researchers said. “This preliminary report indicates that subsequent to attending a two-day CE curriculum...psychiatrists and nurses increased their tobacco-dependence treatment practices.”
To read about smoking-cessation treatment in people with mental illness, see the Psychiatric News article "Smoking Cessation for Patients Called an Urgent Priority."
(Image: courtesy Jill Williams, M.D.)